Hemodialysis principles

Hollow Fiber with Sorbent Walls. A cellulose sorbent and dialy2ing membrane hoUow fiber was reported in 1977 by Enka Glan2stoff AG (41). This hoUow fiber, with an inside diameter of about 300 p.m, has a double-layer waU. The inner waU consists of Cuprophan ceUulose and is very thin, approximately 8 p.m. The outer waU, which is ca 40-p.m thick, consists mainly of sorbent substance bonded by ceUulose. The advantage of such a fiber is that it combines the principles of hemodialysis with those of hemoperfusion. Two such fibers have been made one with activated carbon in the fiber waU, and one with aluminum oxide, which is a phosphate binder (also see Dialysis). 

Peritoneal dialysis (PD) utilizes similar principles as hemodialysis in that blood is exposed to a semipermeable membrane against which a physiologic solution is placed. In the case of PD, however, the semipermeable membrane is the peritoneal membrane, and a sterile dialysate is instilled into the peritoneal cavity. The peritoneal membrane is composed of a continuous single layer of mesothelial cells that covers the abdominal and pelvic walls on one side of the peritoneal cavity, and the visceral organs, including the GI tract, liver, spleen, and diaphragm on the other side. The mesothelial cells are covered by microvilli that increase the surface area of the peritoneal membrane to approximate body surface area (1 to 2 m2). 

Henderson LW. Hemodialysis Rationale and physical principles. In Brenner BM, Rector FC Jr, eds. The kidney. Philadelphia WB Saunders 1976. p. 1643-71. 

Hemodialysis, hemofiltration, and hemodiafiltration Apparatus and principles Factors governing drug removal Hemodialysis in poisoning Hemofiltration and hemodiafiltration in poisoning Hemoperfusion ... 

Figure 3 shows schematically the principle components of the system. Tap water is drawn by a dialysate delivery system (B-D Drake-Willock, Portland, OR) commonly used for hemodialysis. This system produces dialysate at rates of up to 600 ml/min at 38 C by diluting a concentrate with tap water. The freshly made dialysate is piped to a mixing flask containing = 2500 ml of 4500 mosm dialysate. As the dialysate is forced into the flask the dialysate leaving the flask and entering the transport cell varies in osmolality with time according to Table I. 

In-Vivo Percutaneous Implant Experiment. The principle of percutaneous attachment has extensive application in many biomedical areas, including the attachment of dental and orthopedic prostheses directly to skeletal structures, external attachment for cardiac pacer leads, neuromuscular electrodes, energy transmission to artificial heart and for hemodialysis. Several attempts to solve the problem of fixation and stabilization of percutaneous implants(19) have been made. Failures were also attributed to the inability of the soft tissue interface to form an anatomic seal and a barrier to bacteria. In the current studies, the effect of pore size on soft tissue ingrowth and attachment to porous polyurethane (PU) surface and the effect of the flange to stem ratio and biomechanical compliance on the fixation and stabilization of the percutaneous devices have been investigated.(20)... 

FIGURE 41.2 Basic principle of artificial cells Artificial cells are prepared to have some of the properties of biological cells. Like biological cells, artificial cells contain biologically active materials (I). The enclosed material (I) can be retained and separated from undesirable external materials, such as antibodies, leukocytes, and destructive substances. The large surface area and the ultra-thin membrane allow selected substrates (X) and products (Y) to permeate rapidly. Mass transfer across 100 mL of artificial cells can be 100 times higher than that for a standard hemodialysis machine. The synthetic membranes are usually made of ultrathin synthetic polymer membranes for this type of artificial cell. (From Chang, T.M.S., Artif. Cells Blood Substit. ImmobU. Biotechnol., 22(1), vii, 1994.)... 

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